<h1><?php echo $messages['heading1']; ?></h1>

<form method="post">

<table>
<tr>
<td><?php echo $messages['field_heading']; ?></td>
<td><input type="text" name="add_vigyapan[heading]" /></td>
</tr>
<tr>
<td><?php echo $messages['field_desc']; ?></td>
<td><textarea></textarea></td>
</tr>
<tr>
<td><?php echo $messages['field_prod']; ?>1</td>
<td><textarea></textarea></td>
</tr>
<tr>
<td></td>
<td></td>
</tr>
<tr>
<tr>
<td></td>
<td></td>
</tr>
<tr>
<tr>
<td><?php echo $messages['field_addr']; ?></td>
<td><textarea></textarea></td>
</tr>
<tr>
<td><?php echo $messages['field_city']; ?></td>
<td>
<input type="text" name="city"></td>
</tr>
<tr>
<td><?php echo $messages['field_state']; ?></td>
<td><select name="state">
<?php foreach($states as $state) {?>
	<option value="<?php echo $state['id'];?>"><?php echo $state['value'];?></option>
<?php }?>
</select></td>
</tr>

<tr>
<td><?php echo $messages['field_phone']; ?></td>
<td><input type="text" name=""></td>
</tr>
<tr>
<tr>
<td><?php echo $messages['field_mobile']; ?></td>
<td><input type="text" name=""></td>
</tr>
<tr>
<tr>
<td></td>
<td></td>
</tr>

</table>

</form>